Pseudoperitonitis on the background of a ketoacidotic state in a pregnant woman (clinical case)
DOI:
https://doi.org/10.14739/2310-1237.2020.1.203862Keywords:
pregnancy, ketoacidosis, acute abdomen, pseudoperitonitisAbstract
Aim. To present intormation regarding gestational diabetes mellitus, its causes, clinical and laboratory manifestations, and rare course features.
The article presents information regarding gestational diabetes mellitus, its causes, clinical and laboratory manifestations, and rare course features. The article deals with the clinical case of the diagnosis of pseudoperitonitis against the background of ketoacidosis in a pregnant woman with symptoms that mimic acute appendicitis; timely correct diagnosis has been made possible to avoid surgery for the patient (the 34th week of pregnancy). The basics of differential diagnosis of acute abdominal syndrome in women during pregnancy are introduced. The described clinical case is of interest in connection with insufficient literature data on this pathology in pregnant women, as well as in connection with its rarity in the general population.
Conclusions. Careful dynamic monitoring of the pregnant woman and correct interpretation of the laboratory data allow timely diagnosis of ketoacidosis with abdominal pain and avoid unwanted surgery during pregnancy.
References
Babynets, L. S., Myhenko, B. O., Korylchuk, N. I., Botsyuk, N. E., Myhenko, L. M., Starodub, E. M., & Yasnyy, O. R. (2018). Psevdoabdominalnyi syndrom u praktytsi likaria zahalnoi praktyky – simeinoi medytsyny [Pseudo-abdominal syndrome in the practice of a general practitioner – family medicine]. Semeinaya meditsina, (3), 40-44. [in Ukrainian].
Bichkova, Y. O., Medved, V. I., Hominska, Z. B., & Bliznuk, Z. V. (2011). Hormonalni mekhanizmy rozvytku hestatsiinoho diabetu ta rol antyinsulinovykh antytil u vynyknenni tsiiei patolohii [Hormonal mechanisms in the development of gestational diabetes mellitus and the role of anti-insulin antibodies in the origin ofthis pathology]. Zdorov'e zhenshchiny, (2), 128-133. [in Ukrainian].
Kuleshov, E. V. (2013). Prichiny vozniknoveniya, klinicheskie proyavleniya, differentsial'naya diagnostika i lechenie lozhnogo "ostrogo zhivota" pri dekompensatsii sakharnogo diabeta [The causes of a rise, clinical manifestations, differential diagnostics and treatment of the false "acute abdomen" in decompensation of diabetes mellitus]. Mediko-sotsial'nye problemy invalidnosti, (1), 91-97. [in Russian].
Malkov, I. S. (2011). Zabolevaniya, simuliruyushchie ostryi zhivot [Diseases simulating acute abdomen]. Prakticheskaya meditsina, (1), 7-11. [in Russian].
Fes'kov, A. E. (2006). Differentsial'naya diagnostika khirurgicheskoi abdominal'noi patologii na dogospital'nom etape [Differential diagnosis of surgical abdominal pathology at the prehospital stage]. Meditsina neotlozhnykh sostoyanii, (6), 15-21. [in Russian].
Standards of medical care in diabetes-2011. (2011). Diabetes Care, 34(Suppl. 1), S11-61. https://doi.org/10.2337/dc11-S011
Csomor, J., Jirkovska, J., Vedralova, L., Solar, S., Grega, T., Urbanek, P., & Zavoral, M. (2017). Diabetic ketoacidosis with an acute abdomen as a first manifestation of type 1 diabetes mellitus. Acta Endocrinologica-Bucharest, 13(4), 509-511. https://doi.org/10.4183/aeb.2017.509
Gosmanov, A. R., Gosmanova, E. O., & Kitabchi, A. E. (2018). Hyperglycemic Crises: Diabetic Ketoacidosis (DKA), and Hyperglycemic Hyperosmolar State (HHS). In K. R. Feingold, B. Anawalt, A. Boyce et al. (Eds.). Endotext [Internet]. South Dartmouth (MA): MDText.com. https://www.ncbi.nlm.nih.gov/books/NBK279052/
Hagay, Z. J., Weissman, A., Lurie, S., & Insler, V. (1994). Reversal of fetal distress following intensive treatment of maternal diabetic-ketoacidosis. American Journal of Perinatology, 11(6), 430-432. https://doi.org/10.1055/s-2007-994613
Kitabchi A. E., Hirsch I. B., Emmet M. (2018). Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: clinical features, evaluation, and diagnosis. In T. W. Post (Ed.). UpToDate. Waltham : UpToDate.
Metzger, B. E., Coustan, D. R. (1998). Proceeding of the Fourth International Work-shop-Conference on Gestational Diabetes Mellitus. Diabetes Care, 21(Suppl. 2), B1-B167.
Setji, T. L., Brown, A. J. & Feinglos, M. N. (2005). Gestational Diabetes Mellitus. Clinical Diabetes, (30), 17-24. http://dx.doi.org/10.2337/diaclin.23.1.17
Sibai, B. M., Viteri, O. A. (2014). Diabetic ketoacidosis in pregnancy. Obstetrics & Gynecology, 123(1), 167-178. https://doi.org/10.1097/AOG.0000000000000060
Tripathi, B. K., Jain, N., & Kansra, U. C. (2007). Acute abdomeninnon-surgical disorders. Medicine Update. http://www.apiindia.org/contents_mu_2007.html.
Umpierrez, G., & Freire, A. X. (2002). Abdominal pain in patients with hyperglycemic crises. Journal of Critical Care, 17(1), 63-67. https://doi.org/10.1053/jcrc.2002.33030
Wolfsdorf, J. I., Glaser, N., Agus, M., Fritsch, M., Hanas, R., Rewers, A., … Codner, E. (2018). ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatric Diabetes, 19, 155-177. https://doi.org/10.1111/pedi.12701
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